Acta Biomater. 2026 Feb 06. pii: S1742-7061(26)00078-4. [Epub ahead of print]
Ovarian cancer, the gynecological malignancy with the lowest survival rate, is significantly influenced by the tumor microenvironment. The mesenchymal subtype of high-grade serous carcinoma (HGSC) shows poor outcomes due to high stromal and low immune response. Single-cell RNA sequencing (scRNA-seq) of HGSC metastatic ascites has identified carcinoma-associated fibroblasts (CAFs), macrophages, and carcinoma-associated mesenchymal stem cells (CA-MSCs) as crucial drivers of immune exclusion, chemotherapy resistance, metastasis, and stem-like cell propagation. To explore this complex signaling, we developed heterogeneous tri-component tumoroids, incorporating HGSC cells (OVCAR3, OVCAR4, OVCAR8), primary MSCs, and U937-derived M2-like macrophages (M2) in defined ratios, each labeled with a fluorescent protein for distinct analysis. Upon a 48-hour treatment with carboplatin and/or paclitaxel, HGSC cells in tri-component tumoroids exhibited higher chemoresistance than HGSC-only tumoroids. Flow cytometry revealed significant increases in cancer stem-like cell (CSC) markers CD44 and CD90 in the tri-component tumoroids. Conditioned medium from the tri-component tumoroids significantly enhanced HGSC cell migration. Invasion assays further demonstrated that tri-component tumoroids penetrated monolayer of mCherry-labeled LP-9 mesothelial cells more effectively than HGSC-only tumoroid. Additionally, scRNA-seq of tri-component tumoroids identified a unique cancer cell cluster enriched in epithelial-mesenchymal transition (EMT) and matrisome signatures, featuring a 14-gene signature linked to poor survival. MSCs in these tri-component tumoroids displayed a myofibroblastic-CAF signature, while macrophages indicated an ECM-associated and immunosuppressive phenotype. In conclusion, our 3D heterogenous tri-component tumoroids replicate key HGSC phenotypes, such as chemoresistance, CSC enrichment, migration, invasion, and EMT. This platform is invaluable for studying HGSC microenvironment interactions and preclinical testing of targeted therapies. STATEMENT OF SIGNIFICANCE: The cellular composition of the ovarian tumor microenvironment has a profound effect on patients' clinical outcomes, yet effective therapies that target its cellular components remain underexplored. In this study, we introduce a highly tunable 3D in vitro tumoroid model for ovarian cancer that integrates stromal cells, such as mesenchymal stem cells (MSCs) and macrophages, with cancer cells to more accurately recapitulate the complex cell-cell interactions of these heterogeneous tumors. This model facilitates detailed investigation of intercellular signaling pathways, enabling the identification of previously unexplored therapeutic targets. Generated using a 384-well hanging drop array, these tri-component tumoroids are compatible with high-throughput drug screening. This versatile platform can be adapted for a range of stromal cell types, making it broadly applicable for studying ovarian as well as other solid tumor microenvironments.
Keywords: Alternately activated macrophages; Carcinoma-associated mesenchymal stem cells (MSC) (CA-MSC); High grade serous ovarian cancer; Molecular subtyping; Organoids; Spheroids; Tri-component tumoroids; Tumor associated macrophages (TAM); Tumor microenvironment; scRNA-seq